Author Question: A child has a platelet count of 45,000/mm3 with petechiae and excessive bruising covering his body. ... (Read 47 times)

iveyjurea · **on:** Jun 27, 2018

A child has a platelet count of 45,000/mm3 with petechiae and excessive bruising covering his body. The nurse is aware that these signs are clinical manifestations of:

a. erythroblastopenia.
b. von Willebrand's disease.
c. hemophilia.
d. immune thrombocytopenia purpura (ITP).

Question 2

What is an expected outcome for the child with von Willebrand's disease?

a. Prevention of injury
b. Maintaining adequate hydration
c. Compliance with chronic transfusion therapy
d. Prevention of respiratory infections

mammy1697 · **Reply #1 on:** Jun 27, 2018

Answer to Question 1

D
Excessive bruising and petechiae, especially involving the mucous membranes and gums in a child who is otherwise healthy, are the clinical manifestations of ITP, resulting from decreased platelets. The etiology of ITP is unknown, but it is considered to be an autoimmune process. The clinical manifestations of erythroblastopenia are pallor, lethargy, headache, fainting, and a history of upper respiratory infection. The clinical manifestations of von Willebrand's disease are bleeding from the gums or nose, prolonged bleeding from cuts, and excessive bleeding after surgery or trauma. Bleeding is the clinical manifestation of hemophilia and results from a deficiency of normal factor activity necessary to produce blood clotting.

Answer to Question 2

A
Hemorrhage as a result of injury is the child's greatest threat to life. Fluid volume status becomes a concern when hemorrhage has occurred. The treatment of von Willebrand's disease is desmopressin acetate (DDAVP), which is administered intranasally or intravenously. Respiratory infections do not constitute a major threat to the child with von Willebrand's disease.